Primary cutaneous and subcutaneous leiomyosarcomas: evolution and prognostic factors.

Cutaneous and subcutaneous leiomyosarcomas (LMS) are uncommon neoplasms. We reviewed the MEDLINE database to assess their rates of recurrence and metastasis, mortality and recommended follow-up period. Other prognostic factors were also studied. This review included 112 subcutaneous LMS and 313 cutaneous LMS. In subcutaneous LMS, we observed that rates of recurrence, metastasis and mortality were 36.63%, 43.23% and 37.82%, respectively, after a median follow-up period of 4.40 years, while in cutaneous LMS those figures were 24.40%, 4.22% and 3.33%, respectively, after a median follow-up period of 3.45 years. Although subcutaneous and cutaneous LMS show similar morphologic features, the latter show less tendency to recur and metastasize; in certain cases they both may be the cause of death. For these reasons we suggest avoiding the term "atypical intradermal smooth muscle neoplasm". Location, size and histologic grade are essential prognostic factors for superficial LMS. Recurrence after incomplete excision can be avoided when performed with a surgical margin of at least 1 cm. Follow-up should be at least five years.

Selección de color dentario: comparación de los métodos visual y espectrofotométrico / Selection of tooth colour: comparison of visual and spectrophotometric methods

Introducción En odontología la selección de color se realiza mediante métodos visuales o instrumentales: el primero, ampliamente utilizado, es subjetivo e influenciado por diversos factores, en tanto el instrumental con espectrofotómetro es objetivo y simple, pero poco utilizado. Objetivo Comparar los resultados en la selección del color utilizando los métodos visual y el espectrofotómetro Easyshade Compact, para verificar si existen diferencias. Material y método Cincuenta odontólogos, 25 hombres y 25 mujeres, seleccionaron el color de una pieza dentaria anterior sana con el muestrario Vitapan 3D Master, y se compararon los resultados con los obtenidos al utilizar el espectrofotómetro. Los datos se analizaron mediante Chi-cuadrado. Resultados El 18% de los odontólogos (el 24% de las mujeres y el 12% de los hombres) coincidió en la selección visual del color con lo obtenido con espectrofotómetro. Un 76% de las mujeres y un 88% de los hombres no concordaron en la selección visual con respecto a los resultados obtenidos con el espectrofotómetro. Conclusiones Existen diferencias estadísticamente significativas entre la selección del color dentario con el método visual y el espectrofotómetro (p < 0,0005). El género no parecería ser un factor determinante en la selección del color (p < 0,232).

Introduction In cosmetic dentistry the selection of colour can be performed by visual or instrumental methods. The former is subjective, influenced by multiple factors and widely used by dentists, whilst the latter, using a spectrophotometer, is objective and simple but little used. Objective To compare the results in the selection of colour by a visual method and using the Easyshade Compact spectrophotometer, to verify whether there are differences between them. Material and method A total of 50 dentists, 25 men and 25 women, were asked to select the colour of a healthy anterior tooth using the 3D Master Vitapan, and the results were compared with those obtained when using the Easyshade Compact spectrophotometer. The data obtained were analysed using the Chi-squared statistical test. Results The colour obtained by the visual colour selection matched that obtained with spectrophotometer by 18% of dentists. The colour selection by the visual method was different to that obtained with the spectrophotometer for 76% of women and 88% of men. Conclusions There are statistically significant differences between the selection of colour with the visual method and with spectrophotometer (P < .0005). Gender does not seem to be a determining factor in the selection of colour (P < .232).

Myositis ossificans circumscripta without history of trauma.

UNLABELLED: Myositis ossificans circumscripta is a form of heterotopic ossification that is benign in nature associated to a trauma, but may appear clinically and radiologically as a malignant neoplasm. We describe a rare case of calcifying of myositis ossificans not associated to trauma in a 35-year-old woman with a mass in her upper third and external of right thigh. We discuss some of the difficulties of diagnosis and histological evolution of the lesion. KEYWORDS: Myositis ossificans; Thigh; Differential diagnosis; Nontraumatic.

Cutaneous granular cell tumor of the breast: a clinical diagnostic pitfall.

UNLABELLED: We report the clinical-morphological study of a granular cell tumor in dermal/hypodermal junction and subcutaneous fat left breast of an 83-year-old woman with a family history of breast carcinoma. Mammography study showed a spiculated lesion in the lower inner quadrant with suspicion of malignancy. The results of fine needle puncture-aspiration were inconclusive. Subsequent tumorectomy revealed a poorly-defined indurated lesion of 1.1 x 0.7 cm. The histopathology study showed a proliferation of cells with ample and granular cytoplasm that were positive for S100, CD 68 and inhibin and negative for hormonal receptors. We present a benign lesion that clinically reproduces a breast carcinoma. KEYWORDS: Granular cell tumor; Breast; Differential diagnosis; Cutaneous.

Incidence and functional evolution of traumatic injuries of the spine / Incidência e evolução funcional de lesões traumáticas da coluna / Incidencia y evolución funcional de lesiones traumáticas de la columna vertebral

OBJECTIVE: To determine the incidence and functional outcome of traumatic injuries of the spine in the period from January 1, 2013 to December 31, 2013, at the General Hospital "Dr. Rafael Pascacio Gamboa", state of Chiapas, México. METHODS: A retrospective, cross-sectional, descriptive, observational study, where all patients seeking medical and surgical care in the emergency department and inpatient unit for a traumatic spinal injury were included, regardless of age or sex. RESULTS: A sample of 60 patients, of whom 43 were male (71.7%) and 17 females (28.3%), with an average age of 35 was obtained. As for the cause of the injury, falls were the leading cause (61.7%) followed by motor vehicle accidents (35%) and finally, assaults (3.3%). In this sample, 21% had associated injuries being the most common (7.3%) the thoracic trauma. The most common site of injury was the thoracic spine, followed by the lower cervical and finally the thoracolumbar ones. We found that 70% of patients had partial or complete neurological injury, with complete spinal cord transection (Frankel A) being the most frequent lesion in 53%. CONCLUSION: The incidence in our series is similar that the reported in developing countries which have sociocultural problems similar to ours. The same applies to the etiology of these lesions, which is closely linked to social and economic activity in each country or region. .

OBJETIVO: Determinar a incidência e evolução funcional de lesões medulares traumáticas no período de 01 de janeiro de 2013 a 31 de dezembro de 2013, no Hospital Geral "Dr. Rafael Gamboa Pascacio" estado de Chiapas, México. MÉTODOS: Estudo retrospectivo, transversal, descritivo e observacional, onde foram incluídos todos os pacientes que procuraram atendimento médico-cirúrgico na unidade de pronto-socorro e hospitalar, independentemente de idade ou sexo, que tinham lesão traumática na medula espinhal. RESULTADOS: Obteve-se uma amostra de 60 pacientes, dos quais 43 eram homens (71,7%) e 17 mulheres (28,3%), com média de idade de 35 anos. Quanto à causa da lesão, as quedas foram a principal causa (61,7%), seguidas de acidentes com automóveis (35%) e por agressões (3,3%). Do total, 21% dos pacientes tiveram lesões associadas, sendo a mais comum o trauma torácico (7,3%). O local mais comum de lesão foi a coluna torácica, seguido pela cervical baixa e, finalmente, a coluna toracolombar. Verificamos que 70% dos pacientes tiveram lesão neurológica total ou parcial, sendo a transecção completa da medula espinhal (Frankel A) a lesão mais frequente (53%). CONCLUSÃO: A incidência em nossa série é semelhante à relatada em países em desenvolvimento que têm problemas socioculturais semelhantes aos nossos. O mesmo se aplica à etiologia das lesões, que está estreitamente ligada à atividade econômica e social de cada país ou região. .

OBJETIVO: Determinar la incidencia y evolución funcional de las lesiones traumáticas de la columna vertebral en el periodo comprendido del 01 de enero del 2013 al 31 de diciembre del 2013, en el hospital General "Dr. Rafael Pascacio Gamboa" del estado de Chiapas, México. MÉTODOS: Se trata de un estudio retrospectivo, transversal, descriptivo y observacional, donde se incluyeron a todos los pacientes que solicitaron atención médico-quirúrgica en el servicio de urgencias y hospitalización de la unidad, sin importar edad o sexo que presentaron una lesión vertebral traumática. RESULTADOS: Se obtuvo una muestra de 60 pacientes, de los cuales 43 eran del sexo masculino (71,7%) y 17 del sexo femenino (28,3%), con un promedio de edad de 35 años. En cuanto a la causa de la lesión, las caídas ocuparon el primer lugar (61,7%) seguidas de accidentes automovilísticos (35%) y en tercer lugar las agresiones (3,3%). El 21% presentaron lesiones asociadas siendo el trauma torácico el más frecuente (7,3%). El sitio de lesión más habitual fue la columna torácica, seguida de la cervical baja y finalmente las toraco-lumbares. Encontramos que el 70% de los pacientes presentaron lesión neurológica parcial o completa, siendo la sección medular completa (Frankel A) la lesión más frecuente en un 53%. CONCLUSIÓN: La incidencia encontrada en nuestra serie, es similar a la reportada en países en vías de desarrollo quienes cuentan con una problemática sociocultural similar a la nuestra. Lo mismo sucede con la etiología de estas lesiones, la cual se encuentra estrechamente ligada a la actividad social y económica de cada país o región. .

[Papulonecrotic tuberculid]. / Tubercúlides papulonecróticas.

Papulonecrotic tuberculid (PTB) is a form of cutaneous tuberculosis with characteristic clinical and histological manifestations. The incidence of PNT is very low in Spain. We present the case of a 22-year-old male patient from a middle-class social and economic background, with clinical and histological criteria of PNT, but who showed negative for molecular traces of mycobacteria using PCR.

Tubercúlides papulonecróticas / Papulonecrotic tuberculid

La tubercúlide papulonecrótica (TPN) es una forma de tuberculosis cutánea con un cuadro clínico e histológico característico. La incidencia de la TPN en España es muy baja. Presentamos a un paciente de 22 años, de contexto económico-social medio, con criterios clínicos e histológicos floridos de TPN, pero con negatividad para trazas moleculares de micobacterias por reacción en cadena de la polimerasa (PCR)

Papulonecrotic tuberculid (PTB) is a form of cutaneous tuberculosis with characteristic clinical and histological manifestations. The incidence of PNT is very low in Spain. We present the case of a 22-year-old male patient from a middle-class social and economic background, with clinical and histological criteria of PNT, but who showed negative for molecular traces of mycobacteria using PCR